title: Multiple inflammatory and serum amyloid A positive telangiectatic hepatic adenomas with glycogenated nuclei arising in a background of nonalcoholic steatohepatitis.
abstract: The authors describe multiple telangiectatic or inflammatory adenomas in a 53-year-old woman with steatohepatitis who presented with acute right upper quadrant abdominal pain. Magnetic resonance imaging revealed 6 lesions consistent with multiple hepatic adenomas, 2 of which showed hemorrhage. She underwent right lobectomy and nonanatomical segment 2 liver resections and seven nodules ranging in size from 1.0 to 5.0 cm were identified. All nodules contained portal-like structures and ductular reaction, features seen in focal nodular hyperplasia, as well as significant inflammation, telangiectatic sinusoids and immunoreactivity for serum amyloid A, placing them according to a recently described classification systems as telangiectatic or inflammatory adenomas. The diffuse positivity of the serum amyloid A staining results in this case suggests an important diagnostic role of this stain in smaller tissue samples, such as in core biopsy specimens.
authors.affiliation: Department of Pathology, Singapore General Hospital, Singapore.
authors.forename: Kiat H
authors.initials: KH
authors.lastname: Lim
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Ward
authors.forename: Sasan
authors.initials: S
authors.lastname: Roayaie
authors.forename: Emil
authors.initials: E
authors.lastname: Cohen
authors.forename: Myron
authors.initials: M
authors.lastname: Schwartz
authors.forename: M Isabel
authors.initials: MI
authors.lastname: Fiel
authors.forename: Swan N
authors.initials: SN
authors.lastname: Thung
mesh_terms: D000236:Adenoma / Q000453:epidemiology / Q000473:pathology*; D015897:Comorbidity; D005234:Fatty Liver / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D000685:Serum Amyloid A Protein / Q000032:analysis*; D013684:Telangiectasis / Q000473:pathology
chemical_list: D000685:Serum Amyloid A Protein